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August 2020

Gosh, I have missed you! I know it’s been a while since we have “chatted”; strange times for sure. Just like you, I have been busy getting used to the new norm (whatever that is unfolding to be). Now it’s time to get back to routines, restart our “chats” and create my new norm. Reaching out to you each month grounds me and there has been so much going on in the industry with more coming this fall…so let’s get right to it!

A few insurance carrier related specifics for you, in case you have not heard: United Healthcare is phasing out ALL paper checks by the end of 2020. So, if you are one of those offices that is holding onto paper checks, it’s time to switch over to ACH direct deposits for your payments. If you do not switch to ACH direct deposits, UHC will be sending you virtual credit cards to process (which as you know, costs you more money; i.e. when you run a virtual credit card you are paying processing fees). Here is the link below to get you to started with ACH direct deposit. Don’t delay! No one wants to take less from an insurance company: www.UHCProvider.com/payment

Sun Life/DHA is no longer allowing Aetna to access their network for new dental providers. If you are already considered in network with Aetna through Sun Life then things will remain as is – no new providers will be added through this arrangement. Keep this in mind if you have new providers joining your group.

Cigna Dental is no longer allowing providers to terminate their existing network and then rejoin under a new network. If a provider terminates their participation, they will have to reapply and will be given the same fee schedule and network they were in prior to termination. This is a big shift if you are moving from a direct contract to a rental type network.

There is also “big stuff” happening in 2021 that we need to start getting ready for. A complete shift in E&M (evaluation and management ) codes and guidelines for medical carriers is worth mentioning. The current model has been revamped and the new model will be based on medical decision making and time. This new medical decision making criteria is quite different than the current one, so I will be doing training sessions (virtually) in the fall to get you prepared for the changes. I will let you know when the dates and times are scheduled via our next Newsletter so be on the lookout. This will be a big change!

CDT 2021 has many upcoming changes as well. I will go over those with you in the fall as we get closer to January 2021.

Best wishes to you for a safe and healthy end of summer!

Until next time…Keep Calm and Code On!​​​​​​

TERRI

OMS Powerhouse Owner Terri

Terri Bradley, CPC

Terri is the owner of Terri Bradley Consulting and co-founder of OMS Billing Solutions.  With a hands-on background spanning more than 30 years Terri is a practice management expert devoted to her clients.  She is highly sought after for speaking engagements offering medical/dental/OMS coding and billing workshops across the country.

Her publications include “Coding, Billing and Third Party Payers” in the Fonseca Oral and Maxillofacial Surgery textbook 3rd edition, Vol. 1, 2017, Dictations and Coding in Oral and Maxillofacial Surgery which she co-authored in 2017 and she is a contributing author in the CDT Coding Companion: Help Guide for the Dental Team 2017 -2021.

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